Most Relevant Information
Provider Data
| NPI Number: | 1003171547 |
| Provider Name: | MARISSA JANENE MANNETTA LMHC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | MH17360 |
Most Important Dates
| Enumeration Date: | 07/11/2012 |
| Last Updated: | 08/12/2020 |
Provider Practice Location
7635 ASHLEY PARK CT STE 503H
ORLANDO
FL
328356197
Practice Location Phone/Fax
| Phone: | 4079634733 |
| Fax: | 4072159436 |
Provider Mailing Location
7635 ASHLEY PARK CT STE 503H
ORLANDO
FL
328356197
Provider Mailing Phone/Fax
| Phone: | 4079634733 |
| Fax: | 4072159436 |